The overall goals of the program are to determine the factors contributing to the irreversible cerebral damage caused by various forms of hypoxia or ischemia and to apply this information to the clinical situation. In addition, a better understanding of the control of cerebral hemodynamics in the normal situation is being pursued. Various approaches to these problems are being utilized. On a basic level, animal models of stroke and shock are being studied. Regional cerebral blood flow and regional cerebral glucose metabolism as well as mitochondrial function, ion fluxes, cortical redox state, high energy metabolites and ultrastructural changes are being examined. In addition, the development of new methodology applicable to these problems is being pursued. On the clinical level, various forms of cerebrovascular disease are being studied in an attempt to improve the prognosis in these patients. The intensive care and monitoring of patients with acute strokes is being undertaken to determine whether such an approach can favorably alter the outcome in these cases. A new method of managing cerebrovascular accidents in patients with sickle cell anemia is being investigated as is the use of hyperbaric oxygen in the treatment of senile dementia.